• Tuberculosis and Respiratory Diseases
• /
• v.44 no.4
• /
• pp.844-852
• /
• 1997

Background : Recent studies have documented increased release of endothelin(ET) during acute attack of asthma. The purpose of this study is to observe the link between plasma level and urinary excretion of each and changes during acute exacerbation. Method : Plasma and 24 hour urine were collected from sixteen asthmatics during acute exacerbation, twice ; first day of symptomatic exacerbation and two weeks after treatment. Controls were ten healthy normal subjects. All patients were treated with corticosteroid and beta-2 adrenergic agonist on admission. ET was determined by radioimmmunoassay and had 100% cross reactivity with ET-1, 67% with ET-2, 84% with ET-3, and 8% with Big-ET. Results : Plasma ETs were significantly elevated during acute attack of asthma compared with those in remission and controls.,However, there was no significant changes in urine ET concentrations or total ET amounts in 24 hour urine during exacerbation upto two weeks. Those levels of urine ET in asthmatics were still higher than controls. ET concentrations in plasma or urine were not correlated with pulmonary functional parameters and hypoxemia. Conclusion : The findings suggests that increased plasma ETs are related with exaggerated release during acute asthma. Urinary ET excretion is increased in asthma. However, urine ET changes during exacerbation should be observed in a larger and longer scale.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.5
• /
• pp.1019-1029
• /
• 1997

Background : Elevation of resting energy expenditure(REE) in patients with lung cancer has been described in earlier studies and may contribute to cancer cachexia, but limited information is available regarding the prevalence and determinants of the increased REE. The aim of this study was to assess the prevalence and contributing factors of a hypermetabolic state in newly detected patients with lung cancer and to assess the energy balance in order to improve our knowledge about weight loss in patients with lung cancer. Method : Thirty one consecutive, newly detected patients with lung cancer and 20 control patients with benign lung diseases were included in this study. Resting energy expenditure(REE) was measured by indirect calorimetry using ventilated hood system and predicted REE was calculated by the Harris-Benedict formular. Results : The energy balance in newly detected lung cancer patients was disturbed in a high proportion of patients, and hypermetabolic state occurred in 61% of the patients. Tumor volume, cancer type, location, stage, the presence of atelectasis or infiltration, pulmonary function, or smoking behavior were not associated with increase in REE. But patients with distant metastasis had significantly higher REE comparing with patients without metastasis. Thirty nine percents of the patients with lung cancer had substantial loss of more than 10% of their pre-illness weight. Weight losing patients with lung cancer were not accompanied by an increase in REE. Conclusion : We concluded that the REE was elevated in a higher proportion of patients with lung cancer and distant metastasis was found to be contributing factor to the elevated REE.

• Tuberculosis and Respiratory Diseases
• /
• v.57 no.5
• /
• pp.419-424
• /
• 2004

Background : Although bronchodilator reversibility testing is widely performed to diagnose asthma or COPD, there is debate upon its usefulness and methods to differentiate asthma from COPD. The purpose of this study is to elucidate the role of bronchodilator reversibility testing in differentiating asthma from COPD and to confirm which method is better at evaluating bronchodilator reversibility. Methods : 26 asthma patients and 31 COPD patients were reviewed retrospectively. Spirometry was performed before and after bronchodilator inhalation to get $FEV_1$, FVC. To evaluate bronchodilator reversibility, the increase in $FEV_1$ or FVC was expressed as three methods, 'percentage of the baseline value', 'percentage of the predicted value', or 'absolute value'. Area under the ROC curve was measured to compare the three methods. In addition, the criteria of American Thoracic Society (ATS) for bronchodilator reversibility were compared to those of European Respiratory Society (ERS). Results : 1. In differentiating asthma from COPD, 'percentage of the predicted value', or 'absolute value' method was useful but 'percentage of the baseline value' was not. However, the ability to differentiate was weak because areas under the ROC curves by all methods were less than 0.75. 2. The criteria of ERS were superior to those of ATS for bronchodilator reversibility to differentiate asthma from COPD because likelihood ratio (LR) of a positive test by ERS criteria was greater than ATS criteria and because LR of a negative test by ERS criteria was less than ATS criteria. Conclusion : In differentiating asthma from COPD, bronchodilator reversibility testing has a weak role and should be considered as an adjunctive test.

• The Journal of the Korean bone and joint tumor society
• /
• v.6 no.1
• /
• pp.10-16
• /
• 2000

Object : The aim of the current study is to assess the results of segmental resection and replantation for primary malignant or aggressive tumors of the upper limb. Materials and Methods : From 1986 to 1994, ten patients who had primary malignant or aggressive tumors of the upper limb were managed with segmental resection and replantation method. The average duration of follow-up was 7 years and 7 months. Primary indication of this method is stage II B tumors which, because of their extend, could otherwise be adequately treated only by amputation. Three patients had chondrosarcoma, two had osteosarcoma, two had giant cell tumors with pathologic fracture, one had extensive chondroblastoma, one had Ewings sarcoma, and one had leiomyosarcoma. The location of the tumor was humerus in 6 patients, scapula in 3 patients, and soft tissue of forearm in 1 patient. Wide resection margins were achieved in 7 patients and marginal margin in three. Results : One patient died on 40 months after surgery due to systemic metastasis. Nine patients have remained disease free without local recurrence or metastasis. The average overall functional rating was 65% (43~90%) for ten patients on the last follow-up by the functional rating system of Enneking. The mean grasping power and pinching power of operative hand was 75%(28~95%) and 65%(43~90%) of the opposite hand, respectively. Complications associated with this surgical method included three wound dehiscences and one nerve injury that resolved with proper wound care and time. Conclusion : It was concluded that segmental resection and replantation might be used for partial limb salvage in selected cases for the treatment of primary malignant or aggressive tumors of the upper limb.

• The korean journal of orthodontics
• /
• v.29 no.6 s.77
• /
• pp.649-661
• /
• 1999

The goals of this study were 1) to present pre-surgical naso-alveolar molding (PNAM) appliance for bilateral cleft lip and palate treatment and 2) to evaluate the effects of the PNAM appliance on the alveolar molding of the premaxilla and the lateral segments. Subjects consisted of 8 bilateral cleft lip and palate infants (7 males and 1 female, mean age at first visit = 61.6 days after birth) who were treated with PNAM appliances in Department of Orthodontics, Seoul National University Dental Hospital. Average alveolar cleft gap between the premaxilla and the lateral segment was $8.09{\pm}5.03mm$ and average duration of alveolar molding treatment was $8.8{\pm}3.1$ weeks. These patients' models were obtained at initial visit (T0) and after alveolar molding (T1). 20 linear and 14 angular variables were measured by using photometry and digital caliper, All statistical analyses were performed by Microsoft Excel 97 program. Paired t-test was used to discriminate the effect of alveolar molding by PNAM appliance. 1. Closure of the alveolar cleft gap in bilateral cleft cases by molding therapy was completed successfully, 2. Alveolar molding inhibited outward growth of lateral segments and produced inward bending of lateral segments. 3. By bending the anterior part of the vomer, the premaxilla could be rotated and moved. posteriorly via alveolar molding. Conclusion This appliance can be applied to bilateral cleft lip and palate infants with satisfactory results before cheiloplasty.

• The korean journal of orthodontics
• /
• v.30 no.2 s.79
• /
• pp.261-272
• /
• 2000

Severe skeletal anteroposterior and vertical discrepancy is difficult to obtain satisfactory result by only orthodontic treatment, and much anteroposterior movement and treatment stability require orthodontic treatment with orthognathic surgery. The treatment goal of mandibular prognathic patients is to promote the function of stomatognathic system including mastication and phonetics, to improve the esthetics of facial profile and to maintain stability. Positional changes of hyoid bone, pharynx and tongue were seen with mandibular movement after orthognathic surgery. This study was performed to observe the changes of perimandibular tissues of orthodontic patients with skeletal mandibular prognathism who treated with orthodontic treatment, and the changes of hyoid bone, pharyx and tongue by relapse or recurrance after before and after orthognathic surgery and retention. The 22 patients who had mandibular prognathism were selected. They treated with orthodontic treatment with sagittal split ramus osteotomy as orthognathic surgery. And lateral cephalometric radiographs were taken 3 times : pre-surgery (T1), immediate post-surgery (T2) and 2 years alter retention (T3). The results were as follows : 1. The hyoid bone returned back after clockwise rotation to maxilla and occlusal plane during retention (P<0.01). 2. The hyoid bone moved posterior-inferiorly by mandibular surgery and returned back anterior-superior after retention. (P<0.01) 3. The changes of pharyngeal depth showed a little decrease at upper area in post- surgery, but it was not a significant difference generally through before, after and retention. 4. In relating to tongue base, the angle of tongue base was decreased and the dorsal area of tongue base moved to inferior-posterior direction and to superior direction again after retention (P<0.01). 5. Related to the thickness of upper and lower lip, the thickness of upper lip decreased after surgery, and the soft tissues below lower lip increased after surgery and decreased after retention.

• The korean journal of orthodontics
• /
• v.27 no.6 s.65
• /
• pp.963-978
• /
• 1997

Orthodontic patients are individuals that grow and develop ;therefore selection of the proper time for orthodontic treatment Is considered to be one of the most difficult and yet difficult factor.Since the development of cephalometric X-ray, amount and pattern of craniofacial growth change with aging could be predicted and became useful in the process of orthodontic treatment. The relationship between the mean values of cephalometric measurements and body height and weight was studied among the groups(boys and girls) of Korean children from the ages of 3-years to 12-years. 126 boys and 90 girls with no abnormality in growth and development and no history of orthodontic treatment from the ages of 3 years to 12 years were chosen as subjects: Cephalometric X-ray were taken for 2 years and hard tissue analysis based on Burstone's COGS, which was divided into measurements of 6 parts (Cranial base, Maxillar and Mandible, Vertical measurements, Horizontal measurements, Basal bone relationship, Dental measurements). The relationship between craniofacial growth and body height & weight was studied. The following conclusions were obtained : 1. The maximum growth in the measurements of cranial base, N-Ar(FH), N-Ba(FH) corresponded with the age with the maximum increasein body height & weight in both boys and girls. 2. Genial angle gradually decreased with aging in both boys and girls. 3. N-ANS(L) showed greater amount of growth than ANS-Me(L), and this had greater influence on facial profile. 4. $N-A-Pog^{\circ}$ decreased with aging, and mandibular growth exceeded maxillary growth in amount and rate. 5. Length of Y-axis increased, but Y-axis to FH plane remained constant. This show that mandible grows at a constant angulation to cranial base. 6. As Permanent teeth erupt, interincisal angle deceased.

• The korean journal of orthodontics
• /
• v.30 no.2 s.79
• /
• pp.143-157
• /
• 2000

To investigate the developmental stages of dental and skeletal maturation by ages and the correlations among dental maturity, skeletal maturity of cervical vertebrae, and that of hand-and-wrist, the author used the cephalograms, orthopantomograms, and hand-and-wrist radiograms of 1055 patients (male 458, female 597) aged 7 to 20 years old. In the cephalograms, the skeletal maturity stages of each bone were mainly assessed by Hassel and Farman's cervical vertebrae maturation indicators (CVMI) method. In the orthopantomograms, the dental maturity stages of each tooth were mainly assessed by Nolla's tooth calcification stages method. In the hand-and-wrist radiograms, the skeletal maturity stages of each bone were mainly assessed by Fishman's skeletal maturity indicators (SMI) method. The results were as follows. 1. There was a high correlation among dental maturity, skeletal maturity of cervical vertebrae, and that of hand-and-wrist in the both sexes (P<0.001). 2. There was a high correlation (r=0.91-0.93) between skeletal maturity of cervical vertebrae and that of hand-and-wrist. 3. There was a high correlation (r>0.8) between skeletal maturity of hand-and-wrist and maturity of upper and lower canine, first premolar, and second premolar. 4. There was high a correlation(r=0.8) between skeletal maturity of cervical vertebrae and maturity of upper canine. 5. By the ages, dental maturity, skeletal maturity of cervical vertebrae, and that of hand-and-wrist were obtained in the both sexes. In summary, dental maturity, skeletal maturity of cervical vertebrae, and that of hand-and-wrist we of sufficient diagnostic worth as an index to predict adolescent growth.

• Nuclear Medicine and Molecular Imaging
• /
• v.41 no.3
• /
• pp.201-208
• /
• 2007

Purpose: We investigated whether the diagnostic performance of SPECT scintimammography (SMM) can be improved by adding computer-aided diagnosis (CAD) of ultrasonography (US). Materials and methods: We reviewed breast SPECT SMM images and corresponding US images from 40 patients with breast masses (21 malignant and 19 benign tumors). The quantitative data of SPECT SMM were obtained as the uptake ratio of lesion to contralateral normal breast. The morphologic features of the breast lesions on US were extracted and quantitated using the automated CAD software program. The diagnostic performance of SPECT SMM and CAD of US alone was determined using receiver operating characteristic (ROC) curve analysis. The best discriminating parameter (D-value) combining SPECT SMM and the CAD of US was created. The sensitivity, specificity and accuracy of combined two diagnostic modalities were compared to those of a single one. Results: Both SPECT SMM and CAD of US showed a relatively good diagnostic performance (area under curve = 0.846 and 0.831, respectively). Combining the results of SPECT SMM and CAD of US resulted in improved diagnostic performance (area under curve =0.860), but there was no statistical differerence in sensitivity, specificity and accuracy between the combined method and a single modality. Conclusion: It seems that combining the results of SPECT SMM and CAD of breast US do not significantly improve the diagnostic performance for diagnosis of breast cancer, compared with that of SPECT SMM alone. However, SPECT SMM and CAD of US may complement each other in differential diagnosis of breast cancer.

• Development and Reproduction
• /
• v.10 no.1
• /
• pp.55-61
• /
• 2006

There is growing concern that dietary soy intake is associated with protection of breast cancer. However, questions persist on the potential adverse effects of the main soy constituent genistein(GS) on female reproductive physiology. In this study, we examined whether prepubertal exposure to GS affected on the onset of puberty and the associated reproductive parameters such as hormone receptor expressions in female rats. GS(100mg/kg/day) was administrated daily from postnatal day 25(PND 25) to the day when the first vaginal opening(VO) was observed, and the animals were sacrificed on the day after VO occurred. Gross anatomy and tissue weight were compared to test the GS's effect on the cell proliferation. Furthermore, histological studies were performed to assess the structural alterations in tissues. Specific radioimmunoassay(RIA) were carried out to measure serum LH levels. To determine the transcriptional changes in progesterone receptors(PR), total RNAs were extracted from ovary and uterus and were applied to semi-quantitative reverse transcription polymerase chain reaction(RT-PCR). As a results, advanced VO was shown in the GS group(PND $31.2{\pm}0.6$) compared to the vehicle group (PND $35.3{\pm}0.7$). GS treatment significantly increased wet weight of ovaries and uteri compared to the vehicle group. Increased serum LH levels were also shown in the GS group. Graafian follicles and corpora lutea(CL) were observed only in the ovaries from GS treated animals. Similarly, hypertrophy of luminal and glandular uterine epithelium were found only in the GS group. Collectively, these effects were probably due to the estrogenic effects of GS. In the semi-quantitative RT-PCR studies, the transcriptional activities of PR in both ovary and uterus from GS-treated group were significantly higher than those from the vehicle group. The present studies demonstrated that acute exposure to GS, at levels comparable to the ranges of human exposure, during the critical period of prepubertal stage activates the reproductive system resulting precocious puberty in immature female rats.